Doctors, Lawyers Make Friendly Before Things Turn Ugly

In one day, Gurnee surgeon Dr. Richard Furman operated on two gall bladders, conducted a breast biopsy, made rounds at two hospitals and saw 10 patients in his office-all by mid-afternoon.

At every step-at times peering from behind a mask in a blue-green scrub suit-a medical malpractice lawyer was watching.

That may sound like a doctor's Orwellian nightmare, in which a society has grown so litigious that a doctor can't even work without an attorney on hand.

But Waukegan lawyer Scott Gibson, whose practice is mostly personal injury and malpractice cases, was not looking for new cases.

He was shadowing Furman on Tuesday as part of a Lake County Medical Society program designed to open up the normally cloistered, confidential world of doctors to people without medical backgrounds.

It's designed for people whose jobs bump up against the world of doctors, such as lawmakers, insurance claim analysts and attorneys. Held twice a year, the program's purpose is to open the lines of communication between those professionals.

Even in that context, Gibson's presence in operating rooms at Condell Medical Center in Libertyville and Victory Memorial Hospital in Waukegan set off some instinctive alarm bells for Furman.

"I'm in the middle of an operation thinking, `What do I have a medical malpractice attorney here for?' " Furman said incredulously. "I will say it's a unique experience."

Gibson, who said he asked to join the program to educate himself, said he was surprised to be accepted. "I didn't think they'd take a guy like me," he said.

A few years ago, about the only time doctors and malpractice lawyers saw each other was in court.

But as the medical industry is besieged with plans and counter-plans to reduce health care costs and increase insurance coverage, as malpractice insurance premiums rise, and as polls show a majority of Americans demanding "fundamental change" in health care, doctors have become increasingly willing to participate in programs such as the one in Lake County.

Lake County's two-day "mini-internship" program began in 1989, making it the first in the Chicago area. Participants in the program are selected by a committee of six doctors. The Lake County program was followed last year by similar programs sponsored by the Chicago Medical Society and the DuPage Medical Society. The Kane County Medical Society has one in the works.

Nationwide, mini-internship programs went from a handful in the mid-1980s to about 40 in 1992. Since then, they have more than doubled to nearly 100 such programs, an American Medical Association spokeswoman said.

Dr. Ralph Crawshaw, a Portland, Ore., psychiatrist who came up with the idea that led to the first mini-internship in 1976, said there is a direct link between the tumult in health care and the growth in mini-internships.

Doctors are beginning to recognize that the better their field is understood, the better chance they have to avoid drastic changes to the patient-doctor relationship.

"I think it's catching on because doctors are getting anxious," Crawshaw said. "Doctors are aware that they have to have a new constituency that really knows what the product is."

The nine interns-including a pharmaceutical analyst, the county medical services director and a claims supervisor whose organization defends doctors-were wowed by gee-whiz technology.

Some saw orthoscopic eye surgery, or watched a surgeon cutting into a leg to graft bone for a wrist repair.

They also saw the avalanche of paperwork and the complicated approval process that precedes most any procedure these days.

Jon Hotter, a pharmaceutical representative salesman for New Jersey-based Schering Corp., said he came away from the program with a better understanding of the stress and sheer volume of work in a doctor's day.

"I tend not to realize what they go through in a morning in a hospital," Hotter said.

"Sometimes the physicians just don't want to talk to you. I'll be a lot more understanding of that."

Not that the program leaves everyone agreeing with each other.

Terrible things can happen in places where people are supposed to be healed, Gibson said while observing in a hospital emergency room.

He said he is working on a case involving a 35-year-old woman who was admitted to a hospital for a routine test.

Doctors unwittingly punctured an artery during the test and she died, he said.

"The reality is, if you hurt somebody, and you have a duty not to hurt him, you have a responsibility," Gibson said.